Fall is officially here, and I’ve enjoyed some gorgeous fall runs in the high country and am looking forward to more this weekend. After a lot of miles on the bike this summer I’ve been running more recently and feeling strong again. This is always my favorite time of year to be out on the trails with the cooler weather and all the yellow, orange, red and gold fall foliage. I’m hopeful it will be long fall so I can keep getting up high in the mountains to play before the snow comes.

For the last few months, working 18 hours a week has been going really well. This past month of September I decided I would pitch in a little extra at work to help while a coworker was gone.  My 18 hours was great, and I thought picking up an extra six-hour shift every week wouldn’t be a problem. It seemed like a great way to help out and test myself a bit.  For the first two weeks things went pretty well. Sure, I was completely exhausted, but I was holding it together. Most days I had to come home and nap for an hour before dinner, and I would need a nap on my days off, but work itself was fine.

A little sidetrack on naps – before my brain injury, napping was a luxury. Sometimes on the weekends after a long run, I’d lay down and feel like a nap was a treat I could indulge in, because why not? After the brain injury it was no longer a luxury, it was a necessity. Think of your phone battery. If the battery runs down, it doesn’t matter how hard you try, the phone simply does not work. No matter how hard I tried, my brain function was zilch and it was time to power off and recharge. I didn’t want to nap. I didn’t enjoy a nap. I had to nap. For a few years after my TBI, napping was a daily necessity until this spring when I finally reached a point that I was getting through most days without one.  At least until this past month when I started pushing a bit too far and naps once again became non-negotiable.

By the third week of my extra shift, the wheels started to come off the bus. I noticed it was taking me longer to get through an appointment. Making decisions and coming up with a treatment plan took a lot more effort. Then by week four, I started making mistakes. Thankfully, nothing detrimental, but a small mistake here and there was enough to scare me and make me worry I could cause harm. I called a client with the wrong lab results. Immediately upon hanging up the phone I realized the mistake and called her back. She wasn’t upset at all, but I was horrified. Then I sent a client home with the wrong number of pills. It was the correct dose, but half of the number of pills that the patient needed to complete the course of treatment. The worst part was that when the receptionist came back with the bottle and said there weren’t enough pills, I had absolutely no clue how to figure out how many pills were needed. It was towards the end of my shift on the fourth week, and I had nothing left. One of the veterinary technicians jumped in and helped do the calculation and filled the prescription correctly.

Now these examples sound pretty minor, and fortunately they were, but it made me second guess every single calculation. I started triple and quadruple checking every calculation. Writing it down step by step and making sure I got the same answer every time. I also have cheat sheets to check common drug dosages at various patient weights to make sure. It would be easy enough to simply go to the cheat sheet for the dose, but that wouldn’t help my brain learn and improve, so unless I’m running way behind, I make myself do the calculations and then I confirm it on my cheat sheet.

The big problem is that once I push myself into the ditch, it can take weeks to get back out. On Monday of this week I went in and was feeling pretty rough even at the start of my shift. I was trying to prescribe some antibiotics for a cat. The dose range is 1-3 milliliters per 5 pounds. So I kept saying that to myself – 1-3ml per 5 lbs, 1-3ml per 5 lbs, 1-3ml per 5 lbs. It might as well have been in Greek, because my brain could not figure out how to even start that equation. This is a calculation that in the previous months I’ve been able to do in my head without an issue. Overwhelmed, I started crying in the pharmacy.  One of our wonderful staff members was there and she said “Don’t get frustrated. You’ve been working too much. We all know you can do this and you’ve been doing great. Let me help.” This of course made me even more emotional, and I went and hid in the bathroom for a few minutes to pull myself together.

With help, I eventually was able to get medications together for the patient. I am grateful for the team of doctors, technicians, and assistants I work with for believing in me and helping me when I’m stuck. Mercifully, it was not a crazy busy day, and the following day was oddly quiet. Even being off on Wednesday, after a busy Thursday I came home at 4pm, napped for an hour, then went back to bed at 7:30pm, and slept for 11 hours.

Next week a friend is coming into town to visit. I took Thursday off to spend with her and that will give me a much needed break so I can try to fully recover from pushing a bit too hard. While Josh told me I shouldn’t pick up all those extra shifts in the first place, I appreciate the fact he didn’t ever say “I told you so”, even if he was justifiably thinking it.

Every brain injury is a bit different, and although I’ve had a multitude of symptoms over the years, I’m at a point now that on my bad days simple math, processing speed, remembering names (of even close friends), and vertigo can be my biggest issues, oh and reading, and light sensitivity. Okay, so there are a few, and it is easy to get frustrated when I push too far and start to implode. Thankfully I have wonderful people in my life that remind me how far I have come, and how great it is that I am able to work even 18 hours a week.  Once I recover from all the extra shifts, I think I could handle adding an extra hour to my shifts, but I’m clearly not ready for an entire extra day. Maybe by the spring it will be more, maybe not, but I have continued to improve year after year, and I see no reason why those improvements won’t keep happening. I’m not ready for an extra day every week…yet, but I’ll get there.